Josep M. Llovet, MD, PhD, founder and director of the Liver Cancer Program, full professor of medicine, Icahn School of Medicine, Mount Sinai Hospital, discusses the potential for precision medicine in hepatocellular carcinoma (HCC).
The realm of precision medicine involves targeting one driver mutation that causes what researchers dub "oncogenic addiction," meaning the tumor is addicted to this mutation. Ideally, physicians would be able to essentially unplug this addiction with a tyrosine kinase inhibitor or monoclonal antibody. This has been seen in other diseases like HER2-targeted therapy in breast cancer with trastuzumab (Herceptin) or BRAF-targeted agents in melanoma. These personalized therapies have dramatically improved outcomes in those diseases. This has yet to be seen in HCC, mainly because its most prominent driver mutations, p53 and TERT, are not targetable, Llovet says.
This is an area of ongoing research, Llovet adds, and clinical trials are testing targeted agents in less-common driver mutations. So far, this has led to modest response rates.